RSS-Feed abonnieren

DOI: 10.5935/1984-0063.20220066
Web survey during COVID-19 pandemic in São Paulo state: how are medical students sleeping and living?

Objectives This study aimed at characterizing medical students’ sleep and life quality during the COVID-19 pandemic in São Paulo (SP) state.
Material and Methods All public higher education institutions (HEIs) of SP state were invited to participate. From a list of 56 private HEIs, 16 were randomly selected. The web survey collected: sociodemographic data; factors related to COVID-19; sleep self-assessment; scores in the Epworth sleepiness scale, Pittsburgh sleep quality index, and student and resident life in the health area - questionnaire.
Results The HEIs’ acceptance rate was 25% (8), resulting in 200 participants (response rate 5.04%), aged ≥18 years, 60.5% females. Concerning COVID-19, 89.00% never showed symptoms and/or tested positive, 82.00% declared full adherence to epidemiological measures to prevent the infection’s spread, and 45.00% completed the vaccination schedule against SARS-CoV-2. Sleep deprivation was accompanied by a drop of self-perceived sleep quality from 8 to 6 (in a Likert scale) during COVID-19 pandemics (p≤0.0001), 76.50% were poor sleepers, and 40.00% had drowsiness, especially women (p≤0.05). They also had lower quality of life and unfavorable psychological and physical outcomes than men (p≤0.05). Internship students had a more negative perception of the educational environment (p≤0.05), characterized by an excessive workload.
Discussion Women and internship students are a representative fraction that requires special attention and focused strategies to cope with sleep problems and medical education during COVID-19 pandemics.
Funding statement
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Publikationsverlauf
Eingereicht: 26. Juli 2021
Angenommen: 25. Januar 2022
Artikel online veröffentlicht:
01. Dezember 2023
© 2023. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
REFERENCES
- 1 Azad MC, Fraser K, Rumana N, Abdullah AF, Shahana N, Hanly PJ, et al. Sleep disturbances among medical students: a global perspective. J Clin Sleep Med. 2015 Jan;11(1):69-74.
- 2 Li L, Wang YY, Wang SB, Zhang L, Li L, Xu DD, et al. Prevalence of sleep disturbances in Chinese university students: a comprehensive meta-analysis. J Sleep Res. 2018 Jun;27(3):e12648.
- 3 Rao WW, Li W, Qi H, Hong L, Chen C, Li CY, et al. Sleep quality in medical students: a comprehensive meta-analysis of observational studies. Sleep Breath. 2020 Sep;24(3):1151-65.
- 4 Sundas N, Ghimire S, Bhusal S, Pandey R, Rana K, Dixit H. Sleep quality among medical students of a tertiary care hospital: a descriptive cross-sectional study. J Nepal Med Assoc. 2020 Feb;58(222):76-9.
- 5 Tempski P, Perotta B, Pose RA, Vieira JE. A questionnaire on the quality of life of medical students. Med Educ. 2009 Nov;43(11):1107-8.
- 6 Lins L, Carvalho FM, Menezes MS, Porto-Silva L, Damasceno H. Health-related quality of life of students from a private medical school in Brazil. Int J Med Educ. 2015 Nov;6:149-54.
- 7 Solis AC, Lotufo-Neto F. Predictors of quality of life in Brazilian medical students: a systematic review and meta-analysis. Braz J Psychiatry. 2019 Nov/Dec;41(6):556-67.
- 8 Paro HBMS, Perotta B, Enns SC, Gannam S, Giaxa RRB, Arantes-Costa FM, et al. Qualidade de vida do estudante de medicina: o ambiente educacional importa? Rev Med (SaŞo Paulo). 2019 Mar/Apr;98(2):140-7.
- 9 Ghrouz AK, Noohu MM, Manzar MD, Spence DW, Bahammam AS, Pandi-Perumal SR. Physical activity and sleep quality in relation to mental health among college students. Sleep Breath. 2019 Jun;23(2):627-34.
- 10 Memon AR, Gupta CC, Crowther ME, Ferguson SA, Tuckwell GA, Vincent GE. Sleep and physical activity in university students: a systematic review and meta-analysis. Sleep Med Rev. 2021 Aug;58:101482.
- 11 Alsaggaf MA, Wali SO, Merdad RA, Merdad LA. Sleep quantity, quality, and insomnia symptoms of medical students during clinical years. Relationship with stress and academic performance. Saudi Med J. 2016 Feb;37(2):173-82.
- 12 El Hangouche AJ, Jniene A, Aboudrar S, Errguig L, Rkain H, Cherti M, et al. Relationship between poor quality sleep, excessive daytime sleepiness and low academic performance in medical students. Adv Med Educ Pract. 2018 Sep;9:631-8.
- 13 Goweda RA, Hassan-Hussein A, Ali Alqahtani M, Janaini MM, Alzahrani AH, Sindy BM, et al. Prevalence of sleep disorders among medical students of Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia. J Public Health Res. 2021 Jan;9(Suppl 1):2020.
- 14 Miguel AQC, Tempski P, Kobayasi R, Mayer FB, Martins MA. Predictive factors of quality of life among medical students: results from a multicentric study. BMC Psychol. 2021 Feb;9(1):36.
- 15 Oliveira SS, Postal EA, Afonso DH. As escolas médicas e os desafios da formação médica diante da epidemia brasileira da COVID-19: das (in) certezas acadêmicas ao compromisso social. APS Rev. 2020;2(1):56-60.
- 16 Casacchia M, Cifone MG, Giusti L, Fabiani L, Gatto R, Lancia L, et al. Distance education during COVID 19: an Italian survey on the university teachers’ perspectives and their emotional conditions. BMC Med Educ. 2021 Jun;21(1):335.
- 17 Reznik A, Gritsenko V, Konstantinov V, Khamenka N, Isralowitz R. COVID-19 fear in Eastern Europe: validation of the fear of COVID-19 Scale. Int J Ment Health Addict. 2021;19(5):1903-8.
- 18 Javaheri S, Javaheri S. The impact of SARS-CoV-2 on sleep. J Clin Sleep Med. 2020 Aug;16(8):1413.
- 19 Luciano F, Cenacchi V, Vegro V, Pavei G. COVID-19 lockdown: physical activity, sedentary behaviour and sleep in Italian medicine students. Eur J Sport Sci. 2020;21(10):1459-68.
- 20 Marelli S, Castelnuovo A, Somma A, Castronovo V, Mombelli S, Bottoni D, et al. Impact of COVID-19 lockdown on sleep quality in university students and administration staff. J Neurol. 2021 Jan;268(1):8-15.
- 21 Nakhostin-Ansari A, Sherafati A, Aghajani F, Khonji MS, Aghajani R, Shahmansouri N. Depression and anxiety among Iranian medical students during COVID-19 pandemic. Iran J Psychiatry. 2020 Jul;15(3):228-35.
- 22 Nguyen HT, Do BN, Pham KM, Kim GB, Dam HTB, Nguyen TT, et al. Fear of COVID-19 scale-associations of its scores with health literacy and health-related behaviors among medical students. Int J Environ Res Public Health. 2020 Jun;17(11):4164.
- 23 Cao W, Fang Z, Hou G, Han M, Xu X, Dong J, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res. 2020 May;287:112934.
- 24 Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991 Dec;14(6):540-5.
- 25 Bertolazi AN, Fagondes SC, Hoff LS, Pedro VD, Menna Barreto SS, Johns MW. Portuguese-language version of the Epworth sleepiness scale: validation for use in Brazil. J Bras Pneumol. 2009 Sep;35(9):877-83.
- 26 Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989 May;28(2):193-213.
- 27 Bertolazi AN, Fagondes SC, Hoff LS, Dartora EG, Miozzo IC, Barba ME, et al. Validation of the Brazilian Portuguese version of the Pittsburgh sleep quality index. Sleep Med. 2011;12(1):70-5.
- 28 Purim KS, Guimarães AT, Titski AC, Leite N. Sleep deprivation and drowsiness of medical residents and medical students. Rev Col Bras Cir. 2016 Dec;43(6):438-44.
- 29 Kaparounaki CK, Patsali ME, Mousa DV, Papadopoulou EVK, Papadopoulou KKK, Fountoulakis KN. University students’ mental health amidst the COVID-19 quarantine in Greece. Psychiatry Res. 2020 Oct;290:113111.
- 30 Saraswathi I, Saikarthik J, Kumar KS, Srinivasan KM, Ardhanaari M, Gunapriya R. Impact of COVID-19 outbreak on the mental health status of undergraduate medical students in a COVID-19 treating medical college: a prospective longitudinal study. Peer J. 2020;8:e10164.
- 31 Pagnin D, Queiroz V, Carvalho YT, Dutra AS, Amaral MB, Queiroz TT. The relation between burnout and sleep disorders in medical students. Acad Psychiatry. 2014 Aug;38(4):438-44.
- 32 Morin CM, Carrier J, Bastien C, Godbout R; Canadian Sleep and Circadian Network. Sleep and circadian rhythm in response to the COVID-19 pandemic. Can J Public Health. 2020 Oct;111(5):654-7.
- 33 Albqoor MA, Shaheen AM. Sleep quality, sleep latency, and sleep duration: a national comparative study of university students in Jordan. Sleep Breath. 2021 Jun;25(2):1147-54.
- 34 Jahrami H, Alshomili H, Almannai N, Althani N, Aloffi A, Algahtani H, et al. Predictors of excessive daytime sleepiness in medical students: a meta-regression. Clocks Sleep. 2019 Apr;1(2):209-19.
- 35 Machado-Duque ME, Chabur JEE, Machado-Alba JE. Excessive daytime sleepiness, poor quality sleep, and low academic performance in medical students. Rev Colomb Psiquiatr. 2015 Jul;44(3):137-42.
- 36 Hansen SL, Capener D, Daly C. Adolescent sleepiness: causes and consequences. Pediatr Ann. 2017 Sep;46(9):e340-e4.
- 37 Berger M, Hirotsu C, Haba-Rubio J, Betta M, Bernardi G, Siclari F, et al. Risk factors of excessive daytime sleepiness in a prospective population-based cohort. J Sleep Res. 2021;30(2):e13069.
- 38 Abdulghani HM, Alrowais NA, Bin-Saad NS, Al-Subaie NM, Haji AM, Alhaqwi AI. Sleep disorder among medical students: relationship to their academic performance. Med Teach. 2012;34(Suppl 1):S37-S41.
- 39 Fawzy M, Hamed SA. Prevalence of psychological stress, depression and anxiety among medical students in Egypt. Psychiatry Res. 2017 Sep;255:186-94.
- 40 Perotta B, Arantes-Costa FM, Enns SC, Figueiro-Filho EA, Paro H, Santos IS, et al. Sleepiness, sleep deprivation, quality of life, mental symptoms and perception of academic environment in medical students. BMC Med Educ. 2021 Feb;21(1):111.
- 41 Pengo MF, Won CH, Bourjeily G. Sleep in women across the life span. Chest. 2018 Jul;154(1):196-206.
- 42 Bigalke JA, Greenlund IM, Carter JR. Sex differences in self-report anxiety and sleep quality during COVID-19 stay-at-home orders. Biol Sex Differ. 2020 Oct;11(1):56.
- 43 Mallampalli MP, Carter CL. Exploring sex and gender differences in sleep health: a Society for Women’s Health Research Report. J Womens Health (Larchmt). 2014 Jul;23(7):553-62.
- 44 Asaad M, Zayegh O, Badawi J, Hmidi ZS, Alhamid A, Tarzi M, et al. Gender differences in specialty preference among medical Students at Aleppo University: a cross-sectional study. BMC Med Educ. 2020 Jun;20(1):184.
- 45 Van Houten-Schat MA, Berkhout JJ, Van Dijk N, Endedijk MD, Jaarsma ADC, Diemers AD. Self-regulated learning in the clinical context: a systematic review. Med Educ. 2018 Oct;52(10):1008-15.
- 46 Bickerdike A, O’Deasmhunaigh C, O’Flynn S, O’Tuathaigh C. Learning strategies, study habits and social networking activity of undergraduate medical students. Int J Med Educ. 2016 Jul;17:230-6.
- 47 Sharma D, Bhaskar S. Addressing the Covid-19 burden on medical education and training: the role of telemedicine and tele-education during and beyond the pandemic. Front Public Health. 2020 Nov;8:589669.
- 48 Quek TT, Tam WW, Tran BX, Zhang M, Zhang Z, Ho CS, et al. The global prevalence of anxiety among medical students: a meta-analysis. Int J Environ Res Public Health. 2019 Jul;16(15):2735.
- 49 Guo AA, Crum MA, Fowler LA. Assessing the psychological impacts of COVID-19 in undergraduate medical students. Int J Environ Res Public Health. 2021 Mar;18(6):2952.
- 50 Davies EB, Beever E, Glazebrook C. A pilot randomised controlled study of the mental health first aid eLearning course with UK medical students. BMC Med Educ. 2018 Mar;18(1):45.
- 51 Peleias M, Tempski P, Paro HB, Perotta B, Mayer FB, Enns SC, et al. Leisure time physical activity and quality of life in medical students: results from a multicentre study. BMJ Open Sport Exerc Med. 2017 Jun;3(1):e000213.
- 52 World Health Organization (WHO). WHO guidelines on physical activity and sedentary behaviour. Geneva: WHO; 2020.
- 53 Vancini RL, Andrade MS, Viana RB, Nikolaidis PT, Knechtle B, Campanharo CRV, et al. Physical exercise and COVID-19 pandemic in PubMed: two months of dynamics and one year of original scientific production. Sports Med Health Sci. 2021 Jun;3(2):80-92.
- 54 Damiano RF, Oliveira IN, Ezequiel ODS, Lucchetti AL, Lucchetti G. The root of the problem: identifying major sources of stress in Brazilian medical students and developing the Medical Student Stress Factor Scale. Braz J Psychiatry. 2021;43(1):35-42.
- 55 Enns SC, Perotta B, Paro HB, Gannam S, Peleias M, Mayer FB. Medical students’ perception of their educational environment and quality of life: is there a positive association? Acad Med. 2016 Mar;91(3):409-17.
- 56 Muthaura PN, Khamis T, Ahmed M, Hussain SR. Perceptions of the preparedness of medical graduates for internship responsibilities in district hospitals in Kenya: a qualitative study. BMC Med Educ. 2015;15:178.